Dilated Cardiomyopathy Flashcards

1
Q

what is it?

A

This is a dilated flabby heart of unknown cause

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2
Q

what are the associated of DCM? 8

A

alcohol, hypertension, haemochromocytosis, viral infection, autoimmune, peri- or postpartum, thyrotoxicosis, congenital (X-linked)

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3
Q

more common in males , true/false?

A

true

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4
Q

which genes are mutated?

A

Sarcomere and desmosomal

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5
Q

laminA/C and desmin mutation if there is ______ disease

A

laminA/C and desmin if there is conduction disease

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6
Q

mutation in _____ if X linked?

A

dystrophin

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7
Q

what are the risks with DCM?

A
  • Atrioventricular block (first degree heart block)
  • SVT and VA
  • High risk of SCD
    +/-neuromuscular symptoms
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8
Q

what are the symptoms? 6

A
  • fatigue
  • dyspnoea
  • pulmonary oedema
  • RVF
  • Emboli
  • AF, VT arrhythmias
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9
Q

what are the signs of DCM? 1-

A
  • increased pulse, decreased BP
  • increase JVP
  • displaced diffuse apex
  • S3 gallop rhythm
  • mitral or tricuspid regurgitation
  • pleural effusion
  • oedema
  • jaundice
  • hepatomegaly
  • ascites
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10
Q

what investigations should be done?

A
  • blood
  • CXR
  • ECG
  • ECho
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11
Q

in blood tests plasma ___ is sensitive and specific for diagnosing HF

A

BNP

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12
Q

in blood tests decreased __ indicates poor prognosis

A

Na

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13
Q

what are you loooking for on CXR?

A

cardiomegaly, pulmonary oedema

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14
Q

what may be some features of ECG?

A
  • tachycardia
  • non-specific T wave changes
  • poor R wave progression
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15
Q

what are you looking for on echo?

A
  • globally dilated hypokinetic heart and low ejection fraction
  • Look for MR, TR, LV mural thrombus
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16
Q

what is the treatment?

A
  • bed rest
  • drugs
  • biventricular pacing
  • ICDs
  • cardiac transplantation
17
Q

which drugs may be used?

A

diuretics

  • digoxin
  • ACEi
  • anticoagulants
18
Q

when should ICD be considered?

A

in patients with DCM and a confirmed disease causing LMNA mutation and clinical risk factors:

  • male
  • NSVT
  • missense mutations
  • LVEF